ABMP2611 ; IHS/SD/SDR - 3P BILLING 2.6 Patch 11 POST INIT ;
;;2.6;IHS Third Party Billing;**11**;NOV 12, 2009;Build 133
;
Q
POST ;
D ICDEFFDT ;re-populate ICD10 effective date with 10/1/14
D ERRORCD ;create new claim editor error codes
D EXP34 ;add new export mode 34 ADA-2012
D ECODES ;add new 3P Codes entries
D QUES28 ;add question 28 to export mode 27
;
Q:(+$O(^ABMDCODE("AC","H","08",0))'=0)
K DIC,X
S DIC="^ABMDCODE("
S DIC(0)="ML"
S X="08"
S DIC("DR")=".02///H"
S DIC("DR")=DIC("DR")_";.03///TRIBAL 638 PROVIDER-BASED FACILITY"
K DD,DO
D FILE^DICN
Q
ICDEFFDT ;
D BMES^XPDUTL("Auto-populating ICD-10 EFFECTIVE DATE with 10/1/2014 for all insurers...")
S ABMHOLD=DUZ(2)
S DUZ(2)=0
F S DUZ(2)=$O(^ABMNINS(DUZ(2))) Q:'DUZ(2) D
.S ABMDA=0
.F S ABMDA=$O(^ABMNINS(DUZ(2),ABMDA)) Q:'ABMDA D
..S DIE="^ABMNINS("_DUZ(2)_","
..S DA=ABMDA
..S DR=".12////3141001"
..D ^DIE
Q
ERRORCD ;
;HEAT81017
;244 - No providers on claim
K DIC,X
S DIC="^ABMDERR("
S DIC(0)="LM"
S DINUM=244
S X="No Providers on claim"
S DIC("DR")=".02///Add some type of provider"
S DIC("DR")=DIC("DR")_";.03///E"
K DD,DO
D FILE^DICN
D SITE(244)
Q
;
SITE(ABMX) ;
S DUZHOLD=DUZ(2)
S DUZ(2)=0
F S DUZ(2)=$O(^ABMDCLM(DUZ(2))) Q:'+DUZ(2) D
.S DIC(0)="LX"
.S DA(1)=ABMX
.S DIC="^ABMDERR("_DA(1)_",31,"
.S DIC("P")=$P(^DD(9002274.04,31,0),U,2)
.S DINUM=DUZ(2)
.S X=$P($G(^DIC(4,DUZ(2),0)),U)
.S DIC("DR")=".03////"_$S(ABMX=243:"W",1:"E")
.D ^DIC
.K DA,DIC,DINUM
S DUZ(2)=DUZHOLD
K DUZHOLD,DLAYGO,ABMX
Q
EXP34 ;
K DIC,DR,DINUM,DLAYGO,DIE
S DIC="^ABMDEXP("
S DIC(0)="LM"
S DLAYGO=9002274
S X="ADA-2012",DINUM=34
K DD,DO
D ^DIC
Q:Y<0
S DA=+Y
S DIE="^ABMDEXP("
S DR=".04////ABMDF34;.05////ABMDF34X;.06///C;.07///ADA Claim Form dated 2012;.08///1,2,3,4,9,32,33;.11////ABMDES4;.15///H"
D ^DIE
Q
QUES28 ;EP
S ABMQUES=$P($G(^ABMDEXP(27,0)),U,8)
S DIE="^ABMDEXP("
S DA=27
S DR=".08////"_ABMQUES_",28"
D ^DIE
Q
ECODES ;
K DIC,X
F ABMI=1:1 S ABMLN=$P($T(ECODETXT+ABMI),";;",2) Q:ABMLN="END" D
.S ABMCODE=$P(ABMLN,U)
.I $D(^ABMDCODE("AC",$P(ABMLN,U,2),ABMCODE)) D Q
..S DA=$O(^ABMDCODE("AC",$P(ABMLN,U,2),ABMCODE,0))
..S $P(^ABMDCODE(DA,0),U,2)=$P(ABMLN,U,2),$P(^(0),U,3)=$P(ABMLN,U,3),$P(^(0),U,4)=$P(ABMLN,U,4)
.S ABMDESC=$P(ABMLN,U,3)
.S ABMINAC=$P(ABMLN,U,4)
.S DIC="^ABMDCODE("
.S DIC(0)="ML"
.S X=ABMCODE
.S DIC("DR")=".02///"_$P(ABMLN,U,2)
.S DIC("DR")=DIC("DR")_";.03///"_ABMDESC
.S DIC("DR")=DIC("DR")_";.04///"_ABMINAC
.K DD,DO
.D FILE^DICN
VALUE23 ;
;now check for duplicate entries for value code 23
S ABM=0
F ABMI=0:1 S ABM=$O(^ABMDCODE("AC","V",23,ABM)) Q:'ABM
I ABMI<2 Q
S DA=9999
S ABMI=ABMI-1
F ABM=1:1:ABMI D
.S DIE="^ABMDCODE("
.S DA=$O(^ABMDCODE("AC","V",23,DA),-1)
.S DR=".04////1"
.D ^DIE
;
Q
ECODETXT ;
;;03^H^SCHOOL
;;05^N^BORN INSIDE THIS HOSPITAL
;;06^N^BORN OUTSIDE THIS HOSPITAL
;;5^T^TRAUMA
;;01^N^NORMAL BIRTH^1
;;02^N^PREMARTURE BIRTH^1
;;03^N^SICK BABY^1
;;04^N^EXTRAMURAL BIRTH^1
;;1^A^NON-HEALTH CARE FACILITY POINT OF ORIGIN
;;2^A^CLINIC OR PHYSICIAN'S OFFICE
;;3^A^HMO REFERRAL^1
;;5^A^TRANSFER FROM SKILLED NURSING/INTERMEDIATE CARE/ASSISTING LIVING FAC
;;7^A^EMERGENCY ROOM^1
;;9^A^INFORMATION NOT AVAILABLE
;;A^A^Transfer from a Critical Access Hospital
;;B^A^Transfer from Another Home Health Agency
;;D^A^TRANSFER FROM ONE UNIT TO ANOTHER, SAME HOSP, SEPARATE CLAIM TO PAYER
;;E^A^TRANSFER FROM AMBULATORY SURGERY CENTER
;;F^A^TRANSFER FROM HOSPICE FACILITY
;;10^P^DISCHARGED TO MENTAL HEALTH FACILITY
;;30^P^Still Patient
;;43^P^Discharged/transferred to a Federal Health Care Facility
;;51^P^Hospice - Medical Facility (Certified) Providing Hospice Level of Care
;;61^P^Discharged/transferred to a Hospital-Based Medicare Approved Swing Bed
;;62^P^Discharged/transf to IRF incl Rehab Distinct Part Units of a Hospital
;;63^P^Discharged/transf to a Medicare Certified Long Term Care Hosp (LTCH)
;;64^P^Discharged/transf to a Nursing Fac Cert under Medicaid, not Medicare
;;65^P^Discharged/transf to a Psych Hosp or Psych Distinct Part Unit of Hosp
;;66^P^Discharged/transf to a Critical Access Hospital (CAH)
;;70^P^Discharged/transf to another Type of Health Care Inst not Defined
;;72^P^Discharged/Transferred/Referred to this Facility for Outpatient Svcs^1
;;01^P^Discharged to Home or Self Care (Routine Discharge)
;;02^P^Discharged/transferred to a Short-Term General Hospital for Inpt Care
;;03^P^Dischrgd/trans to SNF with Medicare Cert, Anticipation of Skilled Care
;;04^P^Discharged/transf to Facility that Provides Custodial/Supportive Care
;;05^P^Discharged/transf to a Designated Cancer Center or Children's Hospital
;;06^P^Discharged/transf to Home Under Care of an Org Home Hlth Svc Org
;;07^P^Left Against medical Advice or Discontinued Care
;;08^P^Discharged/Transferred to home under care of Home IV Provider^1
;;04^C^Information Only Bill
;;06^C^ESRD Patient in 1st 30 Months of Entitlement Cov by Employer Grp Ins
;;08^C^Beneficiary wouldn't Provide Information Concerning Other Ins Coverage
;;10^C^Patient/Spouse is Employed but NO Employee Group Health Plan Exists
;;11^C^Disabled Beneficiary but NO LGHP
;;30^C^Qualifying Clinical Trials
;;37^C^Ward Accommodation - Patient Request
;;44^C^Inpatient Admission Changed to Outpatient
;;45^C^Ambiguous Gender Category
;;48^C^Psychiatric Residential Tx Centers for Children & Adolescents (RTC)
;;47^C^Transfer from another Home Health Agency
;;49^C^Product Replacement within Product Lifecycle
;;50^C^Product Replacement for Known Recall of Product
;;51^C^Attestation of Unrelated Outpatient Nondiagnostic services
;;52^C^Out of Hospice Service Area
;;55^C^SNF Bed Not Available^1
;;58^C^Terminated Medicare Advantage Enrollee
;;59^C^Non-primary ESRD Facility
;;78^C^New Coverage not Implemented by Managed Care Plan
;;80^C^Home Dialysis - Nursing Facility
;;A7^C^INDUCED ABORTION DANGER TO LIFE^1
;;A8^C^INDUCED ABORTION VICTIM RAPE/INCEST^1
;;AA^C^Abortion Performed due to Rape
;;AB^C^Abortion Performed due to Incest
;;AC^C^Abortion Performed-Serious Fetal Genetic Defect/Deformity/Abnormality
;;AD^C^Abortion Performed due to Life Endangering Physical Condition
;;AE^C^Abortion Performed-Physical Health of Mother not Life Endangering
;;AF^C^Abortion Performed-Emotional/psychological Health of the Mother
;;AG^C^Abortion Performed due to Social or Economic Reasons
;;AH^C^Elective Abortion
;;AI^C^Sterilization
;;AJ^C^Payer Responsible for Co-Payment
;;AK^C^Air Ambulance Required
;;AL^C^Specialized Treatment/bed Unavailable - Alternate Facility Transport
;;AM^C^Non-emergency Medically Necessary Stretcher Transport Required
;;AN^C^Preadmission Screening not Required
;;B0^C^Medicare Coordinated Care Demonstration Claim
;;B1^C^Beneficiary is Ineligible for Demonstration Program
;;B2^C^Critical Access Hospital Ambulance Attestation
;;B3^C^Pregnancy Indicator
;;B4^C^Admission Unrelated to Discharge on Same Day
;;BP^C^Gulf Oil Spill of 2010
;;D4^C^CHANGE IN CLINICAL CODES (ICD) FOR DIAGNOSIS AND/OR PROCEDURE
;;DR^C^Disaster Related
;;H0^C^Delayed Filing-Statement of Intent Submitted
;;H2^C^Discharge by a Hospice Provider for Cause
;;H3^C^Reoccurrence of GI Bleed Comorbid Category
;;H4^C^Reoccurrence of Pneumonia Comorbid Category
;;H5^C^Reoccurrence of Pericarditis Comorbid Category
;;P1^C^Do Not Resuscitate Order (DNR)
;;P7^C^Direct Inpatient Admission from Emergency Room
;;W0^C^United Mine Workers of America (UMWA) Demonstration Indicator
;;W2^C^Duplicate of Original Bill
;;W3^C^Level I Appeal
;;W4^C^Level II Appeal
;;W5^C^Level III Appeal
;;01^O^Accident/Medical Coverage
;;04^O^ACCIDENT/EMPLOYMENT RELATED
;;05^O^Accident/No Medical or Liability Coverage
;;16^O^Date of Last Therapy
;;31^O^Date Beneficiary Notified Of Intent To Bill Accommodations
;;38^O^Date Treatment Started for Home IV Therapy
;;39^O^Date Discharged on a Continuous Course of IV Therapy
;;50^O^Assessment Date
;;51^O^Date of Last Kt/V Reading
;;52^O^Medical Certification/recertification Date
;;54^O^Physician Follow-Up date
;;55^O^Date of Death
;;A4^O^Split Bill Date
;;E1^O^Birthdate-Insured D^1
;;E2^O^Effective Date-Insured D Policy^1
;;E3^O^Benefits Exhausted^1
;;F1^O^Birthdate - Insured E^1
;;F2^O^Effective Date - Insured E Policy^1
;;F3^O^Benefits Exhausted^1
;;G1^O^Birthdate - Insured F^1
;;G2^O^Effective Date - Insured F Policy^1
;;G3^O^Benefits Exhausted^1
;;79^S^Payer Code
;;80^S^Prior Same-SNF Stay Date for Payment Ban Purposes
;;81^S^Antepartum Days at Reduced Level of Care
;;M3^S^ICF Level of Care
;;M4^S^Residential Level of Care
;;04^V^Professional Component Charges which are Combined Billed
;;07^V^MEDICARE PART A CASH DEDUCTIBLE^1
;;21^V^CATASTROPHIC
;;25^V^Offset to the Patient-Payment Amount - Prescription Drugs
;;26^V^Offset to the Patient-Payment Amount - Hearing and Ear Services
;;27^V^Offset to the Patient-Payment Amount - Vision and Eye Services
;;28^V^Offset to the Patient-Payment Amount - Dental Services
;;29^V^Offset to the Patient-Payment Amount - Chiropractic Services
;;33^V^Offset to the Patient-Payment Amount - Podiatric Services
;;34^V^Offset to the Patient-Payment Amount - Other Medical Service
;;35^V^Offset to the Patient-Payment Amount - Health Insurance Premiums
;;37^V^Units of Blood Furnished
;;39^V^Units of Blood Replaced
;;44^V^Amt Prov Agreed to Accept fr 1st Payer, Amt < Chrgs Higher than Pymnt
;;54^V^Newborn Birth Weight in Grams
;;55^V^Eligibility Threshold for Charity Care
;;59^V^Oxygen Saturation
;;66^V^Medicaid Spend Down Amount
;;69^V^State Charity Care Percent
;;73^V^Drug Deductible^1
;;74^V^Drug Coinsurance^1
;;81^V^NON-COVERED DAYS
;;510^V^OUTPATIENT FACILITY CHARGE^1
;;636^V^JCODES^1
;;A0^V^Special ZIP Code Reporting
;;A7^V^Co-payment Payer A
;;A8^V^Patient Weight
;;A9^V^Patient Height
;;AA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer A
;;AB^V^Other Assessments or Allowance (e.g., Medical Education) Payer A
;;B7^V^Co-Payment Payer B
;;BA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer B
;;BB^V^Other Assessments or Allowance (e.g., Medical Education) Payer B
;;C7^V^Co-Payment Payer C
;;CA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer C
;;CB^V^Other Assessments or Allowance (e.g., Medical Education) Payer C
;;D4^V^Clinical Trial Number Assigned by NLM/NIH
;;D5^V^Last Kt/V Reading
;;E1^V^Deductible Payer D^1
;;E2^V^Coinsurance Payer D^1
;;E3^V^Estimated Responsibility Payer D^1
;;F1^V^Deductible Payer E^1
;;F2^V^Coinsurance Payer E^1
;;F3^V^Estimated Responsibility Payer E^1
;;FC^V^Patient Paid Amount
;;FD^V^Credit Received from the Manufacturer for a Replaced Medical Device
;;G1^V^Deductible Payer F^1
;;G2^V^Coinsurance Payer F^1
;;G3^V^Estimated Responsibility Payer F^1
;;G8^V^Facility where Inpatient Hospice Service is Delivered
;;Y1^V^Part A Demonstration Payment
;;Y2^V^Part B Demonstration Payment
;;Y3^V^Part B Coinsurance
;;Y4^V^Conventional Provider Payment Amount for Non-Demonstration Claims
;;END
ABMP2611 ; IHS/SD/SDR - 3P BILLING 2.6 Patch 11 POST INIT ;
+1 ;;2.6;IHS Third Party Billing;**11**;NOV 12, 2009;Build 133
+2 ;
+3 QUIT
POST ;
+1 ;re-populate ICD10 effective date with 10/1/14
DO ICDEFFDT
+2 ;create new claim editor error codes
DO ERRORCD
+3 ;add new export mode 34 ADA-2012
DO EXP34
+4 ;add new 3P Codes entries
DO ECODES
+5 ;add question 28 to export mode 27
DO QUES28
+6 ;
+7 IF (+$ORDER(^ABMDCODE("AC","H","08",0))'=0)
QUIT
+8 KILL DIC,X
+9 SET DIC="^ABMDCODE("
+10 SET DIC(0)="ML"
+11 SET X="08"
+12 SET DIC("DR")=".02///H"
+13 SET DIC("DR")=DIC("DR")_";.03///TRIBAL 638 PROVIDER-BASED FACILITY"
+14 KILL DD,DO
+15 DO FILE^DICN
+16 QUIT
ICDEFFDT ;
+1 DO BMES^XPDUTL("Auto-populating ICD-10 EFFECTIVE DATE with 10/1/2014 for all insurers...")
+2 SET ABMHOLD=DUZ(2)
+3 SET DUZ(2)=0
+4 FOR
SET DUZ(2)=$ORDER(^ABMNINS(DUZ(2)))
IF 'DUZ(2)
QUIT
Begin DoDot:1
+5 SET ABMDA=0
+6 FOR
SET ABMDA=$ORDER(^ABMNINS(DUZ(2),ABMDA))
IF 'ABMDA
QUIT
Begin DoDot:2
+7 SET DIE="^ABMNINS("_DUZ(2)_","
+8 SET DA=ABMDA
+9 SET DR=".12////3141001"
+10 DO ^DIE
End DoDot:2
End DoDot:1
+11 QUIT
ERRORCD ;
+1 ;HEAT81017
+2 ;244 - No providers on claim
+3 KILL DIC,X
+4 SET DIC="^ABMDERR("
+5 SET DIC(0)="LM"
+6 SET DINUM=244
+7 SET X="No Providers on claim"
+8 SET DIC("DR")=".02///Add some type of provider"
+9 SET DIC("DR")=DIC("DR")_";.03///E"
+10 KILL DD,DO
+11 DO FILE^DICN
+12 DO SITE(244)
+13 QUIT
+14 ;
SITE(ABMX) ;
+1 SET DUZHOLD=DUZ(2)
+2 SET DUZ(2)=0
+3 FOR
SET DUZ(2)=$ORDER(^ABMDCLM(DUZ(2)))
IF '+DUZ(2)
QUIT
Begin DoDot:1
+4 SET DIC(0)="LX"
+5 SET DA(1)=ABMX
+6 SET DIC="^ABMDERR("_DA(1)_",31,"
+7 SET DIC("P")=$PIECE(^DD(9002274.04,31,0),U,2)
+8 SET DINUM=DUZ(2)
+9 SET X=$PIECE($GET(^DIC(4,DUZ(2),0)),U)
+10 SET DIC("DR")=".03////"_$SELECT(ABMX=243:"W",1:"E")
+11 DO ^DIC
+12 KILL DA,DIC,DINUM
End DoDot:1
+13 SET DUZ(2)=DUZHOLD
+14 KILL DUZHOLD,DLAYGO,ABMX
+15 QUIT
EXP34 ;
+1 KILL DIC,DR,DINUM,DLAYGO,DIE
+2 SET DIC="^ABMDEXP("
+3 SET DIC(0)="LM"
+4 SET DLAYGO=9002274
+5 SET X="ADA-2012"
SET DINUM=34
+6 KILL DD,DO
+7 DO ^DIC
+8 IF Y<0
QUIT
+9 SET DA=+Y
+10 SET DIE="^ABMDEXP("
+11 SET DR=".04////ABMDF34;.05////ABMDF34X;.06///C;.07///ADA Claim Form dated 2012;.08///1,2,3,4,9,32,33;.11////ABMDES4;.15///H"
+12 DO ^DIE
+13 QUIT
QUES28 ;EP
+1 SET ABMQUES=$PIECE($GET(^ABMDEXP(27,0)),U,8)
+2 SET DIE="^ABMDEXP("
+3 SET DA=27
+4 SET DR=".08////"_ABMQUES_",28"
+5 DO ^DIE
+6 QUIT
ECODES ;
+1 KILL DIC,X
+2 FOR ABMI=1:1
SET ABMLN=$PIECE($TEXT(ECODETXT+ABMI),";;",2)
IF ABMLN="END"
QUIT
Begin DoDot:1
+3 SET ABMCODE=$PIECE(ABMLN,U)
+4 IF $DATA(^ABMDCODE("AC",$PIECE(ABMLN,U,2),ABMCODE))
Begin DoDot:2
+5 SET DA=$ORDER(^ABMDCODE("AC",$PIECE(ABMLN,U,2),ABMCODE,0))
+6 SET $PIECE(^ABMDCODE(DA,0),U,2)=$PIECE(ABMLN,U,2)
SET $PIECE(^(0),U,3)=$PIECE(ABMLN,U,3)
SET $PIECE(^(0),U,4)=$PIECE(ABMLN,U,4)
End DoDot:2
QUIT
+7 SET ABMDESC=$PIECE(ABMLN,U,3)
+8 SET ABMINAC=$PIECE(ABMLN,U,4)
+9 SET DIC="^ABMDCODE("
+10 SET DIC(0)="ML"
+11 SET X=ABMCODE
+12 SET DIC("DR")=".02///"_$PIECE(ABMLN,U,2)
+13 SET DIC("DR")=DIC("DR")_";.03///"_ABMDESC
+14 SET DIC("DR")=DIC("DR")_";.04///"_ABMINAC
+15 KILL DD,DO
+16 DO FILE^DICN
End DoDot:1
VALUE23 ;
+1 ;now check for duplicate entries for value code 23
+2 SET ABM=0
+3 FOR ABMI=0:1
SET ABM=$ORDER(^ABMDCODE("AC","V",23,ABM))
IF 'ABM
QUIT
+4 IF ABMI<2
QUIT
+5 SET DA=9999
+6 SET ABMI=ABMI-1
+7 FOR ABM=1:1:ABMI
Begin DoDot:1
+8 SET DIE="^ABMDCODE("
+9 SET DA=$ORDER(^ABMDCODE("AC","V",23,DA),-1)
+10 SET DR=".04////1"
+11 DO ^DIE
End DoDot:1
+12 ;
+13 QUIT
ECODETXT ;
+1 ;;03^H^SCHOOL
+2 ;;05^N^BORN INSIDE THIS HOSPITAL
+3 ;;06^N^BORN OUTSIDE THIS HOSPITAL
+4 ;;5^T^TRAUMA
+5 ;;01^N^NORMAL BIRTH^1
+6 ;;02^N^PREMARTURE BIRTH^1
+7 ;;03^N^SICK BABY^1
+8 ;;04^N^EXTRAMURAL BIRTH^1
+9 ;;1^A^NON-HEALTH CARE FACILITY POINT OF ORIGIN
+10 ;;2^A^CLINIC OR PHYSICIAN'S OFFICE
+11 ;;3^A^HMO REFERRAL^1
+12 ;;5^A^TRANSFER FROM SKILLED NURSING/INTERMEDIATE CARE/ASSISTING LIVING FAC
+13 ;;7^A^EMERGENCY ROOM^1
+14 ;;9^A^INFORMATION NOT AVAILABLE
+15 ;;A^A^Transfer from a Critical Access Hospital
+16 ;;B^A^Transfer from Another Home Health Agency
+17 ;;D^A^TRANSFER FROM ONE UNIT TO ANOTHER, SAME HOSP, SEPARATE CLAIM TO PAYER
+18 ;;E^A^TRANSFER FROM AMBULATORY SURGERY CENTER
+19 ;;F^A^TRANSFER FROM HOSPICE FACILITY
+20 ;;10^P^DISCHARGED TO MENTAL HEALTH FACILITY
+21 ;;30^P^Still Patient
+22 ;;43^P^Discharged/transferred to a Federal Health Care Facility
+23 ;;51^P^Hospice - Medical Facility (Certified) Providing Hospice Level of Care
+24 ;;61^P^Discharged/transferred to a Hospital-Based Medicare Approved Swing Bed
+25 ;;62^P^Discharged/transf to IRF incl Rehab Distinct Part Units of a Hospital
+26 ;;63^P^Discharged/transf to a Medicare Certified Long Term Care Hosp (LTCH)
+27 ;;64^P^Discharged/transf to a Nursing Fac Cert under Medicaid, not Medicare
+28 ;;65^P^Discharged/transf to a Psych Hosp or Psych Distinct Part Unit of Hosp
+29 ;;66^P^Discharged/transf to a Critical Access Hospital (CAH)
+30 ;;70^P^Discharged/transf to another Type of Health Care Inst not Defined
+31 ;;72^P^Discharged/Transferred/Referred to this Facility for Outpatient Svcs^1
+32 ;;01^P^Discharged to Home or Self Care (Routine Discharge)
+33 ;;02^P^Discharged/transferred to a Short-Term General Hospital for Inpt Care
+34 ;;03^P^Dischrgd/trans to SNF with Medicare Cert, Anticipation of Skilled Care
+35 ;;04^P^Discharged/transf to Facility that Provides Custodial/Supportive Care
+36 ;;05^P^Discharged/transf to a Designated Cancer Center or Children's Hospital
+37 ;;06^P^Discharged/transf to Home Under Care of an Org Home Hlth Svc Org
+38 ;;07^P^Left Against medical Advice or Discontinued Care
+39 ;;08^P^Discharged/Transferred to home under care of Home IV Provider^1
+40 ;;04^C^Information Only Bill
+41 ;;06^C^ESRD Patient in 1st 30 Months of Entitlement Cov by Employer Grp Ins
+42 ;;08^C^Beneficiary wouldn't Provide Information Concerning Other Ins Coverage
+43 ;;10^C^Patient/Spouse is Employed but NO Employee Group Health Plan Exists
+44 ;;11^C^Disabled Beneficiary but NO LGHP
+45 ;;30^C^Qualifying Clinical Trials
+46 ;;37^C^Ward Accommodation - Patient Request
+47 ;;44^C^Inpatient Admission Changed to Outpatient
+48 ;;45^C^Ambiguous Gender Category
+49 ;;48^C^Psychiatric Residential Tx Centers for Children & Adolescents (RTC)
+50 ;;47^C^Transfer from another Home Health Agency
+51 ;;49^C^Product Replacement within Product Lifecycle
+52 ;;50^C^Product Replacement for Known Recall of Product
+53 ;;51^C^Attestation of Unrelated Outpatient Nondiagnostic services
+54 ;;52^C^Out of Hospice Service Area
+55 ;;55^C^SNF Bed Not Available^1
+56 ;;58^C^Terminated Medicare Advantage Enrollee
+57 ;;59^C^Non-primary ESRD Facility
+58 ;;78^C^New Coverage not Implemented by Managed Care Plan
+59 ;;80^C^Home Dialysis - Nursing Facility
+60 ;;A7^C^INDUCED ABORTION DANGER TO LIFE^1
+61 ;;A8^C^INDUCED ABORTION VICTIM RAPE/INCEST^1
+62 ;;AA^C^Abortion Performed due to Rape
+63 ;;AB^C^Abortion Performed due to Incest
+64 ;;AC^C^Abortion Performed-Serious Fetal Genetic Defect/Deformity/Abnormality
+65 ;;AD^C^Abortion Performed due to Life Endangering Physical Condition
+66 ;;AE^C^Abortion Performed-Physical Health of Mother not Life Endangering
+67 ;;AF^C^Abortion Performed-Emotional/psychological Health of the Mother
+68 ;;AG^C^Abortion Performed due to Social or Economic Reasons
+69 ;;AH^C^Elective Abortion
+70 ;;AI^C^Sterilization
+71 ;;AJ^C^Payer Responsible for Co-Payment
+72 ;;AK^C^Air Ambulance Required
+73 ;;AL^C^Specialized Treatment/bed Unavailable - Alternate Facility Transport
+74 ;;AM^C^Non-emergency Medically Necessary Stretcher Transport Required
+75 ;;AN^C^Preadmission Screening not Required
+76 ;;B0^C^Medicare Coordinated Care Demonstration Claim
+77 ;;B1^C^Beneficiary is Ineligible for Demonstration Program
+78 ;;B2^C^Critical Access Hospital Ambulance Attestation
+79 ;;B3^C^Pregnancy Indicator
+80 ;;B4^C^Admission Unrelated to Discharge on Same Day
+81 ;;BP^C^Gulf Oil Spill of 2010
+82 ;;D4^C^CHANGE IN CLINICAL CODES (ICD) FOR DIAGNOSIS AND/OR PROCEDURE
+83 ;;DR^C^Disaster Related
+84 ;;H0^C^Delayed Filing-Statement of Intent Submitted
+85 ;;H2^C^Discharge by a Hospice Provider for Cause
+86 ;;H3^C^Reoccurrence of GI Bleed Comorbid Category
+87 ;;H4^C^Reoccurrence of Pneumonia Comorbid Category
+88 ;;H5^C^Reoccurrence of Pericarditis Comorbid Category
+89 ;;P1^C^Do Not Resuscitate Order (DNR)
+90 ;;P7^C^Direct Inpatient Admission from Emergency Room
+91 ;;W0^C^United Mine Workers of America (UMWA) Demonstration Indicator
+92 ;;W2^C^Duplicate of Original Bill
+93 ;;W3^C^Level I Appeal
+94 ;;W4^C^Level II Appeal
+95 ;;W5^C^Level III Appeal
+96 ;;01^O^Accident/Medical Coverage
+97 ;;04^O^ACCIDENT/EMPLOYMENT RELATED
+98 ;;05^O^Accident/No Medical or Liability Coverage
+99 ;;16^O^Date of Last Therapy
+100 ;;31^O^Date Beneficiary Notified Of Intent To Bill Accommodations
+101 ;;38^O^Date Treatment Started for Home IV Therapy
+102 ;;39^O^Date Discharged on a Continuous Course of IV Therapy
+103 ;;50^O^Assessment Date
+104 ;;51^O^Date of Last Kt/V Reading
+105 ;;52^O^Medical Certification/recertification Date
+106 ;;54^O^Physician Follow-Up date
+107 ;;55^O^Date of Death
+108 ;;A4^O^Split Bill Date
+109 ;;E1^O^Birthdate-Insured D^1
+110 ;;E2^O^Effective Date-Insured D Policy^1
+111 ;;E3^O^Benefits Exhausted^1
+112 ;;F1^O^Birthdate - Insured E^1
+113 ;;F2^O^Effective Date - Insured E Policy^1
+114 ;;F3^O^Benefits Exhausted^1
+115 ;;G1^O^Birthdate - Insured F^1
+116 ;;G2^O^Effective Date - Insured F Policy^1
+117 ;;G3^O^Benefits Exhausted^1
+118 ;;79^S^Payer Code
+119 ;;80^S^Prior Same-SNF Stay Date for Payment Ban Purposes
+120 ;;81^S^Antepartum Days at Reduced Level of Care
+121 ;;M3^S^ICF Level of Care
+122 ;;M4^S^Residential Level of Care
+123 ;;04^V^Professional Component Charges which are Combined Billed
+124 ;;07^V^MEDICARE PART A CASH DEDUCTIBLE^1
+125 ;;21^V^CATASTROPHIC
+126 ;;25^V^Offset to the Patient-Payment Amount - Prescription Drugs
+127 ;;26^V^Offset to the Patient-Payment Amount - Hearing and Ear Services
+128 ;;27^V^Offset to the Patient-Payment Amount - Vision and Eye Services
+129 ;;28^V^Offset to the Patient-Payment Amount - Dental Services
+130 ;;29^V^Offset to the Patient-Payment Amount - Chiropractic Services
+131 ;;33^V^Offset to the Patient-Payment Amount - Podiatric Services
+132 ;;34^V^Offset to the Patient-Payment Amount - Other Medical Service
+133 ;;35^V^Offset to the Patient-Payment Amount - Health Insurance Premiums
+134 ;;37^V^Units of Blood Furnished
+135 ;;39^V^Units of Blood Replaced
+136 ;;44^V^Amt Prov Agreed to Accept fr 1st Payer, Amt < Chrgs Higher than Pymnt
+137 ;;54^V^Newborn Birth Weight in Grams
+138 ;;55^V^Eligibility Threshold for Charity Care
+139 ;;59^V^Oxygen Saturation
+140 ;;66^V^Medicaid Spend Down Amount
+141 ;;69^V^State Charity Care Percent
+142 ;;73^V^Drug Deductible^1
+143 ;;74^V^Drug Coinsurance^1
+144 ;;81^V^NON-COVERED DAYS
+145 ;;510^V^OUTPATIENT FACILITY CHARGE^1
+146 ;;636^V^JCODES^1
+147 ;;A0^V^Special ZIP Code Reporting
+148 ;;A7^V^Co-payment Payer A
+149 ;;A8^V^Patient Weight
+150 ;;A9^V^Patient Height
+151 ;;AA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer A
+152 ;;AB^V^Other Assessments or Allowance (e.g., Medical Education) Payer A
+153 ;;B7^V^Co-Payment Payer B
+154 ;;BA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer B
+155 ;;BB^V^Other Assessments or Allowance (e.g., Medical Education) Payer B
+156 ;;C7^V^Co-Payment Payer C
+157 ;;CA^V^Regulatory Surcharges/Assessments/Allow/Hlth Cre Related Taxes Payer C
+158 ;;CB^V^Other Assessments or Allowance (e.g., Medical Education) Payer C
+159 ;;D4^V^Clinical Trial Number Assigned by NLM/NIH
+160 ;;D5^V^Last Kt/V Reading
+161 ;;E1^V^Deductible Payer D^1
+162 ;;E2^V^Coinsurance Payer D^1
+163 ;;E3^V^Estimated Responsibility Payer D^1
+164 ;;F1^V^Deductible Payer E^1
+165 ;;F2^V^Coinsurance Payer E^1
+166 ;;F3^V^Estimated Responsibility Payer E^1
+167 ;;FC^V^Patient Paid Amount
+168 ;;FD^V^Credit Received from the Manufacturer for a Replaced Medical Device
+169 ;;G1^V^Deductible Payer F^1
+170 ;;G2^V^Coinsurance Payer F^1
+171 ;;G3^V^Estimated Responsibility Payer F^1
+172 ;;G8^V^Facility where Inpatient Hospice Service is Delivered
+173 ;;Y1^V^Part A Demonstration Payment
+174 ;;Y2^V^Part B Demonstration Payment
+175 ;;Y3^V^Part B Coinsurance
+176 ;;Y4^V^Conventional Provider Payment Amount for Non-Demonstration Claims
+177 ;;END
